多学科协作诊疗模式在抢救危险性上消化道出血致失血性休克中的疗效研究

Research on the curative effect of multidisciplinary collaborative diagnosis and treatment model in rescuing hemorrhagic shock caused by dangerous upper gastrointestinal bleeding

目的探讨多学科协作诊疗模式(MDT)在抢救危险性上消化道出血致失血性休克中的应用效果。方法回顾性分析2020年1月至2020年12月我院收治的危险性上消化道出血致失血性休克患者的临床资料,将2020年1月至12月采用非MDT模式诊疗的55例患者纳入对照组;将2020年1月至12月采用MDT模式诊疗的55例患者纳入MDT组。比较两组间年龄差异、发病时间、Rockall评分、Glasgow Blatchford scoring(GBS)评分、治疗总有效率、输血量、住院时间、住院总费用、病因诊断率、再出血率、住院死亡率等指标。结果与非MDT组比较,MDT组患者诊治总有效率显著提高(P<0.05),输血量明显减少,住院时间缩短,住院总费用降低,病因诊断率提高,再出血率及住院死亡率明显下降,差异均具有统计学意义(P<0.05)。结论多学科协作诊疗模式能提高危险性上消化道出血致失血性休克患者抢救成功率,降低死亡率,同时减轻患者负担,具有临床推广应用价值。

Objective To explore the application effect of multidisciplinary collaborative diagnosis and treatment model(MDT)in rescuing hemorrhagic shock caused by dangerous upper gastrointestinal bleeding.Methods The clinical data of patients with hemorrhagic shock caused by dangerous upper gastrointestinal bleeding treated in our hospital from January 2020 to December 2020 were analyzed retrospectively.55 patients treated with non MDT mode from January to December 2020 were included in the control group;55 patients treated with MDT mode from January to December 2020 were included in the MDT group.The age difference,onset time,Rockall score,Glasgow Blatchford scoring(GBS)score,total effective rate of treatment,blood transfusion volume,hospitalization time,total hospitalization cost,etiological diagnosis rate,rebleeding rate and hospitalization mortality rate were compared between the two groups.Results Compared with non-MDT group,the total effective rate of diagnosis and treatment of patients in MDT group was significantly improved(P<0.05),the amount of blood transfusion was significantly reduced,and the hospitalization time was shortened.The total hospitalization expenses decreased,the etiological diagnosis rate increased,the re-bleeding rate and the hospitalization mortality rate decreased significantly,and the differences were statistically significant(P<0.05).Conclusions Multidisciplinary collaborative diagnosis and treatment mode can improve the rescue success rate of patients with hemorrhagic shock caused by dangerous upper gastrointestinal bleeding,reduce the mortality rate,and reduce the burden of patients at the same time,it has the value of clinical popularization and application.